Cindy Elfira Boom
Departemen Anestesiologi dan Terapi Intensif Fakultas Kedokteran Universitas Padjadjaran/Rumah Sakit Dr. Hasan Sadikin Bandung

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Perbandingan Penambahan Neostigmin 2 mg/kgBB dengan Fentanil 1 µg/kgBB dalam Bupivakain 0,125% sebagai Anestesi Kaudal terhadap Lama Analgesia Alam, Jauharul; Oktaliansah, Ezra; Boom, Cindy Elfira
Jurnal Anestesi Perioperatif Vol 1, No 3 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Blokade kaudal dengan injeksi tunggal sering digunakan untuk penatalaksanaan nyeri intra dan pascabedah pada pasien pediatrik. Penelitian ini bertujuan mengkaji lama analgesi setelah blokade kaudal injeksi tunggal preoperatif antara penambahan neostigmin 2 µg/kgBB dan fentanil 1 µg/kgBB dalam bupivakain 0,125% (volume 0,5 mL/kgBB) pada pasien anak yang menjalani operasi hipospadia dalam anestesi umum di Rumah Sakit Dr. Hasan Sadikin Bandung pada bulan Desember 2011–Februari 2012. Metode penelitian adalah penelitian eksperimental secara acak terkontrol buta ganda pada 24 anak berusia 1–7 tahun. Data pengukuran lama analgesi diperoleh dengan Children and Infant Postoperative Pain Scale (CHIPPS) yang dianalisis dengan Uji Mann-Whitney, data laju nadi dan laju napas dianalisis dengan uji-t. Hasil perhitungan statistik diperoleh lama analgesi pada kelompok BN lebih panjang mencapai 675 menit dibandingkan dengan kelompok BF 480 menit dengan hasil yang sangat bermakna (p<0,001). Simpulan penelitian ini menunjukkan bahwa penggunaan kombinasi bupivakain 0,125% dan neostigmin 2 µg/kgBB untuk blokade kaudal injeksi tunggal memberikan lama analgesia yang lebih panjang.Kata kunci: Anestesi kaudal, bupivakain, fentanil, lama analgesia, neostigminComparison between Caudal Blockade with Additional 2 µg/kgBW Neostigmine and 1 µg/kgBW Fentanyl to 0.125% Bupivacaine on the Duration of AnalgesiaAbstractSingle shot injection caudal blockade were used extensively for intra and post operative pain management in pediatric patients. The purpose of this study was to assess duration of analgesia following a single shot injection of caudal blockade with additional 2 µg/kgBW neostigmine and 1 µg/kgBW fentanyl into 0.125% bupivacaine (volume 0.5 mL/kgBW) in pediatric patients who underwent hypospadias surgery at Dr. Hasan Sadikin Hospital Bandung from December 2011 to February 2012. This experimental study was conducted using randomized control trial (RCT) method in 24 pediatric patients, aged 1–7 years. The duration of analgesia data were obtained using Children and Infant Pain Scale (CHIPPS) post operatively and analyzed using Mann-Whitney Test, whereas the heart rate and respiratory rate data were analyzed by t-test. The result of statistical analysis showed significant difference between duration of analgesia in group BN (675 minutes) compared with the BF group (480 minutes) with p<0.001. The conclusion of this study was that combination of 0.125% bupivacaine and 2 µg/kgBW neostigmine as a single shot injection in caudal blockade provides longer duration of analgesia compared to 0.125% bupivacaine and 1 µg/kgBW fentanyl combination.Key words: Bupivacaine, caudal anesthesia, duration of analgesia, neostigmine DOI: 10.15851/jap.v1n3.191
Perbandingan Pemulihan Bising Usus pada Pasien Pascaoperasi Histerektomi per Laparotomi Menggunakan Analgetik Kombinasi Ketamin-Morfin dengan Morfin Intravena Setiawan, Irvan; Oktaliansah, Ezra; Boom, Cindy Elfira
Jurnal Anestesi Perioperatif Vol 2, No 1 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Disfungsi gastrointestinal merupakan penyulit pascaanestesi yang sering terjadi. Tujuan penelitian ini untuk membandingkan pemulihan bising usus antara pemberian analgetika kombinasi ketaminmorfin dibandingkan dengan morfin. Penelitian dilakukan dengan uji klinis acak terkontrol buta ganda terhadap 36 pasien dengan status fisik American Society of Anesthesiologist (ASA) I dan II yang menjalani operasi histerektomi per laparotomi di Rumah Sakit Dr. Hasan Sadikin Bandung pada April–Agustus 2012. Kedua kelompok menerima dosis awal morfin 0,03mg/kgBB, lalu kelompok K diberikan infus ketamin 4 μg/kgBB/menit, dan kelompok M diberikan morfin infus 10 μg/kgBB/jam. Analisis data memakai uji-t dan Uji Mann Whitney, tingkat kepercayaan 95% dan bermakna bila p<0,05. Hasil penelitian ini menunjukkan waktu pemulihan bising usus pada kelompok K lebih cepat dibandingkan dengan kelompok M dengan berbeda bermakna (p<0,05). Simpulan, pemulihan bising usus lebih cepat pada pemberian analgetika kombinasi ketamin dan morfin dibandingkan dengan morfin pada pasien pascaoperasi histerektomi per laparotomi.Kata kunci: Ketamin, morfin, pemulihan bising usus Comparison of Bowel Sound Recovery in Postoperative Hysterectomy per Laparotomy Patient Between Combination of Intravenous Ketamine - Morphine and MorphineGastrointestinal dysfunction is the most common post anaesthesia complication. The aim of this study is to compare the recovery of bowel sounds between combination of ketamine-morphine analgesia to morphine alone. This is a randomized controlled study on 36 patients with American Society of Anesthesiologist (ASA) physical status I and II who underwent hysterectomy per laparotomy at Dr. Hasan Sadikin Bandung during April–August 2012. Both groups received an initial dose of morphine 0.03 mg/kgBW, while K group received intravenous ketamine 4 μg/kgBW/min, and the M group received morphine 10 μg/kgBW/hr. The results were analyzed using t-test and Mann Whitney test with a confidence level of 95% and were considered significant if p<0.05. The results of this study showed that the recovery time of bowel sounds in K group was significantly faster than in the M group (p<0.05). In conclusion, recovery of bowel sounds is faster in analgesia using combination of ketamine-morphine than morphine in postoperative hysterectomy per laparotomy patients.Key words: Ketamine, morphine, recovery of bowel DOI: 10.15851/jap.v2n1.238
Pengaruh Anestesi Umum dibanding dengan Anestesi Spinal untuk Seksio Sesarea terhadap Suhu Rektum Bayi Baru Lahir Rahmat, Rahmat; Pradian, Erwin; Boom, Cindy Elfira
Majalah Anestesia dan Critical Care Vol 34 No 3 (2016): Oktober
Publisher : Perdatin Pusat

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Abstract

Teknik anestesi spinal dan anestesi umum keduanya mengganggu mekanisme termoregulasi. Masih kurang informasi tentang pengaruh teknik anestesi yang dipakai untuk seksio sesarea terhadap suhu tubuh bayi baru lahir. Tujuan penelitian ini untuk menentukan apakah ada perbedaan suhu rektum bayi baru lahir dengan seksio sesarea dihubungkan dengan teknik anestesi yang dipakai. Wanita hamil sebanyak 60 orang secara acak mendapat anestesi umum atau anestesi spinal. Suhu inti ibu diukur tiga kali dengan termometer membran timpani saat induksi, insisi uterus dan saat bayi lahir. Suhu rektum bayi diukur segera setelah lahir. Usia ibu, berat badan, tinggi badan, body mass index (BMI), suhu ibu sesaat sebelum induksi dan suhu ruangan tidak berbeda bermakna pada kedua kelompok. Interval waktu mulai induksi anestesi sampai bayi lahir pada kelompok anestesi spinal ratarata 18,24 menit (SD=2,862) dan kelompok anestesi umum rata-rata 6,47 menit (SD=3,082).Volume cairan pada kelompok anestesi spinal rata-rata 946,6 mL (SD=225,57) dan pada kelompok anestesi umum rata-rata 715,0 mL (SD=133,36), nilai P<0,05. Suhu rektum bayi pada kelompok anestesi spinal rata-rata 37,19oC (SD=0,256) dan pada kelompok anestesi umum rata-rata 37,59oC (SD=0,2288), nilai P<0.05. Suhu rektum bayi lebih rendah padakelompok anestesi spinal dibanding dengan kelompok anestesi umum, tetapi tidak mencapai batas hipotermi. Hal ini akibat pada anestesi spinal terjadi redistribusi panas dari inti ke perifer yang lebih besar, pada penelitian ini ditemukan pula pada anestesi spinal memerlukan lebih banyak cairan intravena dan Interval mulai anestesi sampai bayi lahir lebih panjang. Kata kunci: Anestesi spinal, anestesi umum, suhu membran timpani, suhu rektum bayi, seksio sesarea The Effect Of General Anesthesia Compared to Spinal Anesthesia in Cesarian Section on Newborn Rectal TemperatureBoth spinal anesthesia and general anesthesia interfere thermoregulation mechanism. There are less information on the effect of anesthesia technique applied in cesarean section on newborn rectal temperature. The aim of the study was to determine whether there was a different rectal temperature of the newborn babies with cesarean section in related to using different anesthesia techniques. Sixty pregnant women were randomLy assigned either to general anesthesia group or spinal anesthesia group. The maternal core temperature was measured triplicately with tympanic membrane thermometer at induction, uterine incision, and birth. The rectal temperature of thebabies was promptly measured after delivery. The age, weight, height, BMI, and temperature before induction of the mothers, as well as the room temperature were non-significantly different in both groups. The mean time interval, from anesthesia induction to infant delivery in spinal anesthesia was 18.24 (SD=2.862) minutes and that in general anesthesia was 6.47 (SD=3.082). The mean fluid volume in spinal anesthesia was 946.6 (SD=225.57) mL and that in general anesthesia was 715.0 (SD=133.36) mL, with P<0.05. The mean infant rectal temperature in spinal anesthesia was 37.19 (SD=0.256) °C and that in general anesthesia was 37.59 (SD=0.2288) °C, with p<0.05. The infant rectal temperature was lower in spinal anesthesia compared to that in general anesthesia; but it did notreach hypothermic limit. This was due to that in the spinal anesthesia, there are a greater heat redistribution from core to periphery, a need of more intravenous fluid, and a prolonged interval from anesthesia initiation to infant birth. Key words: Cesarean section, general anesthesia, newborn rectal temperature, spinal anesthesia, tympanicmembrane temperature
Prinsip Proteksi Sel Otot Jantung dalam Mesin Pintas Jantung Paru pada Prosedur Pembedahan Jantung Terbuka Indrasutanto, Teddy Ferdinand; Boom, Cindy Elfira
Jurnal Komplikasi Anestesi Vol 5 No 1 (2017): Volume 5 Number 1 (2018)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v5i1.7324

Abstract

Cardiovascular disease is still the leading cause of global death. At 2004, there are 17.1 million deaths caused by cardiovascular disease which is 29% of total overall death in the world. Coronary artery bypass graft (CABG) surgery is still the gold standard to treat cardiovascular disease. CABG surgery could be done using cardiopulmonary bypass machine so the heart could be stopped from beating for the entire procedure. Cardiopulmonary bypass and CABG procedure itself could cause myocardial injury. There should be a good understanding about cardiovascular physiology before using cardiopulmonary bypass, especially at myocardial protection strategy. The goal of myocardial protection during heart surgery is to avoid injury that is caused by cardiopulmonary bypass machine and ischemia. Cardioplegia is the main factor to help obtain the target of myocardial protection. Cardioplegia could induce cardiac arrest and give nutrition to the myocard at the same time. There are other strategies that could be used to obtain myocardial protection, like hypothermia technique, anesthesia preconditioning using volatile anesthesia and intravenous anesthesia agent. There are a lot of studies on myocardial protection right now, and the future strategies are focused on molecular physiology of the myocard.
Manajemen Anestesi Perioperatif Operasi Bypass Jantung pada Pasien dengan Fraksi Ejeksi 26 % dan Regurgitasi Aorta Berat Tanpomas, Irvan; Boom, Cindy Elfira
Jurnal Anestesi Perioperatif Vol 13, No 2 (2025)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v13n2.4452

Abstract

Penyakit jantung koroner (PJK) merupakan kondisi ketika suplai darah ke miokardium tidak optimal akibat pengerasan dan penyempitan arteri koroner, dan menjadi penyebab 26,4% kematian di Indonesia. Regurgitasi aorta adalah aliran balik darah pada fase diastole dari aorta ke ventrikel kiri yang terjadi akibat kegagalan koaptasi katup aorta, baik karena kelainan pada daun katup aorta maupun akar aorta. Kondisi ini menyebabkan beban volume berlebih pada atrium dan ventrikel kiri, meningkatkan tekanan ventrikel kiri, menimbulkan disfungsi ventrikel, serta mengurangi perfusi koroner. Laporan kasus ini membahas manajemen anestesi pada pasien laki-laki berusia 65 tahun dengan PJK dan regurgitasi aorta berat yang menjalani operasi bypass arteri koroner dan penggantian katup aorta di Rumah Sakit Jantung dan Pembuluh Darah Harapan Kita pada Maret 2025. Pasien dengan fraksi ejeksi rendah dan regurgitasi aorta memerlukan strategi anestesi yang cermat karena berisiko mengalami penurunan curah jantung, berkurangnya perfusi sistemik, serta perburukan kondisi hemodinamik. Operasi berlangsung selama 5,5 jam, pasien dipindahkan ke unit perawatan intensif, dilakukan ekstubasi 24 jam pascaoperasi, dan dirawat selama 4 hari di ruang intensif.